Vasculitic Peripheral Neuropathy, Differences Between Systemic and Non-Systemic Etiologies: A Case Series and Biopsy Report.
J Neuromuscul Dis
; 8(1): 155-161, 2021.
Article
em En
| MEDLINE
| ID: mdl-33104037
ABSTRACT
BACKGROUND:
Vasculitic peripheral neuropathy (VPN) is caused by vessel inflammation leading to peripheral nerve injury of acute-to-subacute onset. When VPN occurs in the context of systemic disease it is classified as Systemic Vasculitic Neuropathy (SVN) and as Non-Systemic Vasculitic Neuropathy (NSVN) when restricted to the nerves.OBJECTIVE:
This study aimed to compare the clinical characteristics, biopsy findings and disease outcome in patients with VPN.METHODS:
Clinical records of adult patients with VPN diagnosed at our institution between June-2002 and June-2019 were retrospectively reviewed. Demographic characteristics, clinical manifestations, nerve conduction studies, nerve biopsies, treatment and clinical evolution were analyzed in all patients with at least 6 months follow-up.RESULTS:
Twenty-five patients with VPN were included (SVN, nâ=â10; NSVN, nâ=â15). No significant differences in demographic or clinical features were found between groups. The median delay between symptom onset and nerve biopsy was significantly longer in NSVN patients (10 vs 5.5 months, pâ=â0.009). Erythrocyte sedimentation rate (ESR) values over 20âmm/h were significantly more common in SVN patients (100% vs. 60%, pâ=â0.024). Nerve biopsies showed active lesions more frequently in treatment-naive patients compared to those who had received at least 2 weeks of corticosteroids (92% vs 38%; pâ=â0.03), with a higher proportion of definite VPN cases (92 vs 46%; pâ=â0.04).CONCLUSIONS:
Although the clinical manifestations are similar, ESR is an important tool to help distinguish between both conditions. Early nerve biopsy in untreated patients increases diagnostic accuracy, avoiding misdiagnosis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vasculite
/
Doenças do Sistema Nervoso Periférico
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Neuromuscul Dis
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Argentina